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10. <br />11.I am providing the following items within my booth for warewashing: <br /> Three compartment sink. <br />OR <br />12. <br />13. <br />14. <br />“Important** <br />15.Completed by: <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />Propane Stove Bleach <br />01 <br />Propane Tank <br />Rinse Water Bleach and Water <br />Fire Extinguisher <br />Page 8 of 11 TEMP EVENT APP <br />■ '..................................... <br />Health Permit <br />_z <br />Soap and Water <br />EHD 16-02 <br />7/14/15 <br />Extra <br />Water <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket- <br />bleach & water for <br />storing wiping cloths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, ora Tarp. <br /> Ice chests Refrigerator <br /> Refrigerated truck ice bath and tubs <br />0 Other (specify) Commercial Freezer Cart <br />Stemo w/Chaffing <br />Dish <br />5-20 Gal. <br />Hand wash Water <br />Extra Ice Bags & Food Containers must be <br />stored 6 inches off of the ground! <br />4/19/19 <br />Date <br />Owner/General Mgr. <br />Title <br />1 I <br />0 Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />Names of responsible persons to be present in booth during all hours of operation <br />Michael Dabney & Chris Williams <br />Ice Cooler <br />1 a™Proyidin9 the following cold temperature control for the cold holding of potentially hazardous foods below <br />45 F (if food is used the following day, maintain below 41 °F temperature): <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my booth: <br />0 Water supply dispenser with warm water at a minimum of 10CTF (i.e. 5-20 gallon container with spigot). A <br />separate tub (bucket or basin) for the collection of rinse/wastewater. Paper towels and a pump-stvle soap <br />container. —1--------- <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils: <br />0 Detergent, bleach, wiping cloths (cleaning towels), and a tub to store wiping cloths in bleach solution. <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. A copy of this checklist must be in the booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event. <br />// ! j ' -I <br />/ Signature <br />/ )